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Evidence-based Practice and Quality Improvement

Effect of single-dose dexmedetomidine on coughing during emergence from sevoflurane-remifentanil anaesthesia after thyroidectomy

1AP7-8

Lee, J. S.; Kim, H. J.; Kang, Y. L.; Soh, S. R.; Shim, Y. H.

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European Journal of Anaesthesiology (EJA): June 2013 - Volume 30 - Issue - p 26-26
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Background and Goal of Study: Coughing during emergence from general anaesthesia may lead to dangerous effects including laryngospasm, detrimental haemodynamic changes. Post-thyroidectomy bleeding occurs in 1-4% of patients, and severe coughing may cause bleeding. Dexmedetomidine, a potent α adrenoreceptor agonist, is theoretically appropriate for reducing airway and haemodynamic reflexes during emergence from anaesthesia.

In this study, we invesgated wheather intravenous single-dose decmedetomidine at the end of surgery reduces coughing during extubation after thyroidectomy.

Materials and Methods: 89 ASA I - II patients, aged between 18 and 75 yr, having elective thyroidectomy were divided into 2 groups. 15 minutes before end of surgery, remifentanil was reduced to 1 ng ml-1 by target effect-site concentration, and maintained 5min after extubation. Patients randomly allocated to receive either dexmedetomidine 0.5 μg kg-1 (Group D) (n = 47) or saline placebo (Group P) (n = 42) intravenously over 10 min in a double-blind design. After infusion of study drug, sevoflurane was reduced to 1% 5 min before end of surgery. The coughing grades (incidence and severity) before/during/ after extubation were evaluated.

Results and Discussion:

Table 1. Patients' characteristics and operation details. Values are mean (SD) or number.

Table 2. Emergence profile. Values are mean (SD), or number (proportion)

[Table 2] * p < 0.05

Conclusion(s): Additional single-dose of dexmedetomidine 0.5 μg kg-1 during emergence from sevoflurane-remifentanil anaesthesia reduces the severity of coughing without serious adverse event. However, awakening may be delayed.

© 2013 European Society of Anaesthesiology